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Are The Allied Health Professions Missing Something?

For the last four years I’ve been teaching a large postgraduate course that helps allied health professionals to think critically about themselves as professionals, their professions, and the many others their work brings them into contact with.

The activity-based course runs for a whole semester, and attracts 70 or more students from areas as diverse as counselling, midwifery, nursing, occupational therapy, paramedicine, physiotherapy, podiatry, and vocational rehab.

Yet despite their diverse backgrounds, what they share in common is an almost complete lack of any knowledge or experience of thinking sociologically.

Most have a very good background in the biological sciences. A smaller number are familiar with subjective, relational aspects to people’s lived experience. But almost none have any real knowledge of Max Weber, Judith Butler, Karl Marx, or Michel Foucault.

That’s shocking in some ways, but also not surprising.

In my own profession – physiotherapy – there has never been any space in the undergraduate curriculum for social theory or social constructivist ways of thinking. Even the social determinants of health – considered by many to be far more important than pathology of behaviour in determining peoples’ long term health and wellbeing – are almost entirely ignored.

Back in 2017, I wrote a long book exploring the history of this, and the reasons why physiotherapists focus so much on the body-as-machine (Nicholls, 2017).

Earlier this year I wrote a new book looking at the physiotherapy profession sociologically (Nicholls, 2021). And in it, I drew on a lot of the work I’d done with the students in my PG course.

The End of Physiotherapy (2017) and Physiotherapy Wise (2021) by David A. Nicholls

Amongst other things, we explore people’s disillusionment with healthcare, and talk about Karl Marx’s concept of alienation. We look at how our professions have pursued prestige (Weber – capital). We examine the patriarchal, colonial history of Western medicine (Said – orientalism and Butler – performativity), and the way we discipline ourselves and others (Foucault – governmentality).

Until recently, only nurses and doctors had made a concerted effort to understand the value of social theory to their professions, Susan Nancarrow and Alan Borthwick’s new book has really brought home the importance of sociology for allied health professionals.

So if you are eager to improve the system, wondering about the next step in your career, or just looking for some fresh ideas and inspiration, think about reading some sociology.

Sociology may be the last, vast unexplored landscape of healthcare practice, and might radically transform what you do, and how you do it.

References

Nancarrow, S. & Borthwick, A. (2021). The Allied Health Professions – A Sociological Perspective. Bristol, UK: Policy Press

Nicholls, D.A. (2017). The end of physiotherapy. Abingdon, Oxon: Routledge

Nicholls, D.A. (2022). Physiotherapy Otherwise. Tuwhera Open Access free pdf/ebook. Also available in low-cost paperback from major online book retailers.